Schuitmaker J J, Baas P, van Leengoed H L, van der Meulen F W, Star W M, van Zandwijk N
Department of Ophthalmology, Academic Hospital of the University of Leiden, Sylvius Laboratory, Netherlands.
J Photochem Photobiol B. 1996 Jun;34(1):3-12. doi: 10.1016/1011-1344(96)07342-3.
The first reports on photodynamic therapy (PDT) date back to the 1970s. Since then, several thousands of patients, both with early stage and advanced stage solid tumours, have been treated with PDT and many claims have been made regarding its efficacy. Nevertheless, the therapy has not yet found general acceptance by oncologists. Therefore it seems legitimate to ask whether PDT can still be described as "a promising new therapy in the treatment of cancer". Clinically, PDT has been mainly used for bladder cancer, lung cancer and in malignant diseases of the skin and upper aerodigestive tract. The sensitizer used in the photodynamic treatment of most patients is Photofrin, (Photofrin, the commercial name of dihematoporphyrin ether/ester, containing > 80% of the active porphyrin dimers/oligomers (A.M.R. Fisher, A.L. Murphee and C.J. Gomer, Clinical and preclinical photodynamictherapy, Review Series Article, Lasers Surg. Med., 17 (1995) 2-31). It is a complex mixture of porphyrins derived from hematoporphyrin. Although this sensitizer is effective, it is not the most suitable photosensitizer for PDT. Prolonged skin photosensitivity and the relatively low absorbance at 630 nm, a wavelength where tissue penetration of light is not optimal, have been frequently cited as negative aspects hindering general acceptance. A multitude of new sensitizers is currently under evaluation. Most of these "second generation photosensitizers" are chemically pure, absorb light at around 650 nm or greater and induce no or less general skin photosensitivity. Another novel approach is the photosensitization of neoplasms by the induction of endogenous photosensitizers through the application of 5-aminolevulinic acid (ALA). This article addresses the use of PDT in the disciplines mentioned above and attempts to indicate developments of PDT which could be necessary for this therapy to gain a wider acceptance in the various fields.
关于光动力疗法（PDT）的首批报道可追溯到20世纪70年代。从那时起，数千名患有早期和晚期实体瘤的患者接受了PDT治疗，并且人们对其疗效提出了许多主张。然而，该疗法尚未得到肿瘤学家的普遍认可。因此，询问PDT是否仍可被描述为“癌症治疗中有前景的新疗法”似乎是合理的。临床上，PDT主要用于膀胱癌、肺癌以及皮肤和上呼吸道消化道的恶性疾病。大多数患者光动力治疗中使用的敏化剂是血卟啉衍生物（Photofrin，二血卟啉醚/酯的商品名，含有>80%的活性卟啉二聚体/寡聚体（A.M.R. Fisher、A.L. Murphee和C.J. Gomer，临床和临床前光动力疗法，综述系列文章，《激光外科与医学》，17（1995年）2 - 31））。它是一种源自血卟啉的卟啉复杂混合物。尽管这种敏化剂有效，但它不是PDT最适合的光敏剂。皮肤光敏性延长以及在630nm处相对较低的吸光度（在该波长下光的组织穿透不理想）经常被认为是阻碍其被普遍接受的负面因素。目前正在评估多种新型敏化剂。这些“第二代光敏剂”大多是化学纯的，在约650nm或更长波长处吸收光，并且不会引起或较少引起全身皮肤光敏性。另一种新方法是通过应用5 - 氨基乙酰丙酸（ALA）诱导内源性光敏剂来使肿瘤产生光敏作用。本文论述了PDT在上述学科中的应用，并试图指出PDT为在各个领域获得更广泛认可可能需要的发展方向。
